Can radiotherapy help patients with trigeminal neuralgia?

Stereotactic radiotherapy or radiosurgery is a radiation treatment that focuses high doses of radiation on the affected nerve root or ganglion, which is often used to treat trigeminal neuralgia when medications are no longer effective or do not provide adequate relief. It aims to damage or destroy the nerve fibers responsible for transmitting the pain signals and provide long-term pain control. The procedure is typically done using highly specialized equipment, such as a gamma knife or linear accelerator.

Stereotactic radiosurgery involves:

1. Detailed Imaging: High-resolution imaging techniques like MRI or CT scans are used to create a precise map of the trigeminal nerve and the surrounding structures.

2. Treatment Planning: A team of radiation oncologists, neurosurgeons, and medical physicists work together to determine the exact location and dose of radiation that is required to target the affected nerve while minimizing damage to healthy tissue.

3. Immobilization: The patient is positioned in a comfortable and fixed position, usually with the help of a stereotactic frame or mask, to ensure accuracy during the procedure.

4. Focused Radiation Delivery: Using advanced technology, the radiation is precisely delivered to the targeted area with pinpoint accuracy. The radiation dose is administered in a single session or over multiple sessions, depending on the treatment plan.

The effectiveness of stereotactic radiosurgery for trigeminal neuralgia varies among individuals, and long-term pain relief rates can range from 60% to 90%. The procedure is generally well-tolerated, and potential side effects include temporary facial numbness or tingling, which typically resolve over time. However, in rare cases, more serious complications like corneal damage or hearing loss can occur.

Overall, stereotactic radiosurgery provides an alternative or adjunctive treatment option for patients with trigeminal neuralgia who have not responded well to medications or are not suitable for surgical intervention. The decision regarding the most appropriate treatment approach is usually made in consultation with experienced medical professionals specializing in the field of pain management and neurosurgery.